Cardio-oncology & otherCohort study
Infective Endocarditis in Patients Addicted to Injected Opioid Drugs
- Retrospective cohort study
- single-centre
- competing-risks analysis
- machine learning
Authors' conclusion
Infective endocarditis surgery can be performed with low mortality in persons who inject drugs, but addiction is far more lethal.
Study context
- Population
- Persons who inject drugs undergoing surgery for infective endocarditis at a quaternary hospital, January 2010 to June 2020age 36 ± 9.9 years
- Participants
- 227 persons
- Outcome
- Postsurgery loss to follow-up, injection drug use relapse and death (competing risks) and their risk factors
- Follow-up
- 1 and 5 years
Main finding
As reported in the abstract
Conditional probabilities after surgery
- Loss to follow-up at 1 year
- 16% (68% CI: 13%-22%)
- Loss to follow-up at 5 years
- 59% (68% CI: 44%-65%)
- Relapse at 1 year
- 32% (68% CI: 28%-34%)
- Relapse at 5 years
- 79% (68% CI: 74%-83%)
- Mortality at 1 year
- 21% (68% CI: 18%-23%)
- Mortality at 5 years
- 68% (68% CI: 62%-72%)
Observational data: associations, not effects.
Further findings
Predictors of relapse
- Younger age, heroin use and lower education level predicted relapse
Drug use and psychosocial issues
- Heroin most self-reported drug injected
- n = 183 [81%]
- Homelessness
- n = 56 [25%]
- Justice system involvement
- n = 150 [66%]
- Depression
- n = 118 [52%]
- Anxiety
- n = 104 [46%]
- Post-traumatic stress disorder
- n = 33 [15%]
Medication for opioid use disorder prescribed at discharge
- Increased from 2010 to 2020
- 0% in 2010 to 100% in 2020
In-hospital death
- Died in-hospital
- 4 (1.8%)
Original publication
Infective Endocarditis in Patients Addicted to Injected Opioid Drugs. J Am Coll Cardiol. Published 27 February 2024. doi:10.1016/j.jacc.2023.12.016
Summarised from the published abstract; every number is checked against it